Use of Webcam as Arthroscopic Training Model for Junior Surgical Trainees

BACKGROUND

An increasing proportion of elective orthopaedic procedures are being performed arthroscopically. However, the steep learning curve and reduced operative exposure following the introduction of the European Working Time Directive has left junior doctors with limited opportunities to acquire arthroscopic skills. We report a simple and inexpensive arthroscopic training model using webcam.

TECHNIQUE

We attached a webcam at 30° tilt to one end of outer sheath of an embolectomy catheter. After connecting this assembly to a computer, an illuminated cardboard box was used to simulate a knee arthroscopic model. Tasks of increasing complexity can be performed such as following along straight lines, complex figures or contours of three-dimensional objects. A second portal in the box can be used for inserting another rod for achieving triangulation and manoeuvring the webcam around simulated cruciate ligaments in the box allowed mimicking movement between compartments of knee.

DISCUSSION

Commercial arthroscopic models have a limited availability and are expensive. Use of webcam has been explored for laparoscopic skills training,¹ but a similar application has not been reflected in arthroscopy. Although the picture definition is not as good, the assembly is inexpensive costing around £10. Moreover, it is extremely simple to make and can be used repetitively with most computers beyond the confines of an operating theatre. Although this can hardly be a substitute for performing arthroscopy on real patients, it can improve triangulation skills and hand-to-eye co-ordination.

Figure 1.

A webcam attached to outer plastic sheath of an embolectomy catheter.

Figure 2.

Assembly of webcam in the trainer box attached to a computer.

Figure 3.

A simple model of the knee representing compartments and the cruciate ligaments.

Figure 4.

Triangulation and movements between the compartments.